Beyond 7 billion: Bending the population curve

In the 1980s, Iran had among the highest birthrates in the Middle East, with the average Iranian woman bearing seven children. In less than two decades, the fertility rate had dropped to two children per mother, setting a world record for the speed of fertility transition.

There are lessons to be learned from Iran's turnaround, which was completely voluntary and occurred under a conservative Islamic government that had initially helped spark a baby boom by restricting opportunities outside the home for women.

Three factors help explain Iran's success in winning the population, including the rural poor, over to family planning.

First, five years before beginning to advocate smaller families, the government started building rural clinics across the country. By the time the call came for smaller families, women had come to trust their health providers and were thus more likely to accept family planning advice when it was offered.

A second reason for Iran's success is that the government trained and employed young local women as health workers. They knew the clients they served and could act as role models.

And third, the health system was active rather than passive. If a married woman failed to show up at the clinic at least once a year, a health worker visited her at home.

Once women signed on to family planning, they saw the benefits, including greater opportunities for themselves and their children. But it's too early to declare victory. This fall, Iran's supreme leader, Ayatollah Ali Khamenei, begged forgiveness from God for having gone "too far with family planning."

Djavad Salehi-Isfahani is a professor of economics at Virginia Tech and a nonresident senior fellow at the Brookings Institution.

Pop culture's role

By William N. Ryerson

As important as contraceptive supplies are to limiting population growth, they are only part of the story. We also need to address why people aren't using birth control, even when they have access to it.

Surveys reveal that many couples in the developing world want far more than two children. In Nigeria, for example, the average married couple wants eight children. Other reasons people don't embrace contraception include fear of health effects, spousal opposition, religious opposition and a belief that God should determine the number of children a woman has.

This situation requires education to help people understand the health and economic benefits for them and their children in limiting and spacing births. It requires modeling good family planning and overcoming fears and cultural taboos. It requires getting husbands and wives to talk to each other about contraception.

To address the cultural and informational barriers to smaller families, our organization, Population Media Center, produces locally written radio and TV serial dramas in which key characters embrace such things as family planning, schooling for girls and other social and health goals unique to each country.

The shows are gripping and entertaining, but they are also educational, and there is strong evidence of dramatic results in the 45 countries in which our programs have aired. For example, in northern Nigeria, where our radio serial was heard regularly by more than 70% of the population, a study found that about two-thirds of those seeking contraception cited the program as a motivating factor. Those who listened to the program also reported wanting fewer children. In Rwanda, listeners were 50% more likely than non-listeners to want three or fewer children. And during the 2 1/2 years our program aired in Ethiopia, 40% of listeners reported using modern contraceptive methods, compared with 25% of non-listeners.

Motivational communications, when accompanied by access to family planning services, work. We need to make this combination a high priority.

William N. Ryerson is president of the Population Media Center.

Religion as an asset

By Carl Pope